The American Journal Of Clinical Nutrition[JOURNAL]
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200 papers
The role of human milk oligosaccharides in shaping and restoring infant gut microbiota: population-based cohort study.
Ovaska M, Tamminen M, Lahdenperä M … +5 more , Rautava S, Jeevannavar A, Isokääntä H, Bode L, Lagström H
Am J Clin Nutr · 2026 Jun · PMID 41999953 · Full text
BACKGROUND: Infant gut microbiota colonization is important for supporting normal development and long-term health of children. Human milk oligosaccharides (HMOs) influence the composition of the gut microbiota, but thei...
BACKGROUND: Infant gut microbiota colonization is important for supporting normal development and long-term health of children. Human milk oligosaccharides (HMOs) influence the composition of the gut microbiota, but their specific effects, particularly after breastfeeding, remain poorly understood. OBJECTIVES: We aimed to deepen the understanding of how HMOs associate with the gut microbiota composition at 3 mo and at 13 mo of age. In addition, we assessed the role of HMOs as microbiome-rebalancing agents in cesarean-delivered infants. METHODS: We analyzed fecal samples from infants at 3 mo (n = 517) and 13 mo (n = 522), along with human milk samples at 3 mo, from a population-based cohort. Gut microbiota was profiled by 16S rRNA sequencing, and 19 HMOs were quantified by high-performance liquid chromatography with fluorescent detection. Dirichlet multinomial mixtures clustering was used to identify bacterial fecal community types (FCTs) and multinomial logistic regression models to study the association between HMOs and FCTs. Permutational multivariate analysis of variance and linear regression models were used to associate HMOs with gut microbiota diversity measures and Spearman correlation to bacterial genera. RESULTS: HMOs were associated with gut microbiota FCTs, diversity measures, and bacterial genera at 3 and 13 mo of age. At 3 mo, disialyllacto-N-tetraose and the structurally related lacto-N-sialyllactose b showed notable associations with the gut microbiota, whereas at 13 mo, fucodisialyllacto-N-hexaose was associated with multiple gut microbiota metrics. Maternal secretor status was associated with the gut microbiota beta diversity (R = 0.003, P < 0.05) and decreased Shannon diversity (b = -0.24, P < 0.05) at 3 mo, with diminishing associations at 13 mo (observed richness, b = -11, P < 0.05). Although no individual HMOs showed microbiome-rebalancing effects in cesarean-born infants, infants fed by nonsecretor mothers exhibited stronger cesarean-related microbiota patterns compared with those fed by secretors. CONCLUSIONS: HMOs exhibit age-dependent and structure-specific associations with infant gut microbiota, extending beyond breastfeeding.
Eating while distracted: a systematic review and meta-analysis of the effect of distraction on concurrent and later energy intake in adults.
Gough T, Mann T, Ahmadyar K … +4 more , Finlay I, Jones A, Tapper K, Robinson E
Am J Clin Nutr · 2026 Jun · PMID 41999952 · Full text
BACKGROUND: Eating while distracted [e.g., television (TV) watching, phone use] is believed to increase food intake. A previous small meta-analysis of experimental studies (published in American Journal of Clinical Nutri...
BACKGROUND: Eating while distracted [e.g., television (TV) watching, phone use] is believed to increase food intake. A previous small meta-analysis of experimental studies (published in American Journal of Clinical Nutrition) supported this. Many studies have since been published, but there has been no updated analysis. OBJECTIVES: This study aimed to conduct an updated systematic review and meta-analysis to examine the effect of distraction on concurrent and later energy intake. METHODS: Eligible articles (searching up to December 2024) were identified from: a previously conducted meta-analysis which included studies up until 2012; database searches from 2012 to 2024 (PsycINFO, Medline, and PubMed); and both forward and backward citation searching. We followed PRISMA guidelines and conducted generic variance inverse meta-analyses with intake as the outcome variable for both concurrent and later energy intake. RESULTS: A total of 50 eligible studies were included (40 measuring concurrent intake, 10 measuring later intake). Random effects meta-analyses revealed that the overall effect of distraction on concurrent energy intake was nonsignificant [standardized mean difference (SMD) = 0.123, 95% confidence interval (CI): <-0.01, 0.25; P = 0.051]. Moderator analyses revealed that type of distractor moderated the effect of distraction on eating, with passive distractor tasks (e.g., TV watching) resulting in greater energy intake when distracted [SMD = 0.272 (95% CI: 0.128, 0.417)], whereas physically demanding distractors [SMD = -0.139 (95% CI: -0.334, 0.057)] and cognitively demanding distractors [SMD = 0.202 (95% CI: -0.028, 0.432)] did not. The effect of distraction on later energy intake was statistically significant, such that eating while distracted led to greater intake at a subsequent eating episode [SMD = 0.419 (95% CI: 0.195, 0.642)]. CONCLUSIONS: Distracted eating increases later energy intake; however, the effect of distracted eating on concurrent energy intake is less consistent, and only relatively passive distractors may increase energy intake. Collectively, these findings suggest that distraction is a potential contributor to overeating. This systematic review and meta-analysis was registered at PROSPERO as CRD42024518245.
Identifying temporal eating patterns: a comparison of latent class analysis and dynamic time warping-based cluster analysis.
Jima BR, Leech RM, Dunstan DW … +2 more , Kouzani AZ, McNaughton SA
Am J Clin Nutr · 2026 Jun · PMID 41997454 · Full text
BACKGROUND: Temporal eating patterns (TEPs) are associated with diet quality and obesity, although inconsistencies exist because of variations in methods and input variables. Direct comparisons of analytical approaches f...
BACKGROUND: Temporal eating patterns (TEPs) are associated with diet quality and obesity, although inconsistencies exist because of variations in methods and input variables. Direct comparisons of analytical approaches for deriving TEPs are rare. OBJECTIVES: The aim of this study was to compare latent class analysis (LCA) and modified dynamic time warping (MDTW)-based cluster analysis for deriving TEPs and examine their associations with diet quality and obesity. METHODS: This cross-sectional study included 672 adults (18-65 y) in Victoria, Australia, from the "EveryDayLife" survey (2017-2020). Participants completed a 1- to 7-d food diary via the "FoodNow" app. LCA used hourly presence/absence of eating occasions (EOs), whereas MDTW-based clustering used hourly energy intake (EI) input variables. Methods were compared using patterns visualization, membership overlap, kappa statistics, adjusted R, and AUC. RESULTS: Both methods identified 3 distinct TEPs. Class 1/Cluster 1 had peaks during 07:00-09:00, 12:00, and 18:00-19:00 h ("conventional" pattern). Class 2/Cluster 2 had later peaks in EOs or EI (after 13:00 h). Class 3/Cluster 3 showed modest, evenly spaced EOs or EI concentrated earlier in the day. Membership overlap between similar TEPs was 56.2%-73.1%, with fair agreement (κ = 0.38, P < 0.001). Class 1/Cluster 1 showed higher diet quality than Class 2/Cluster 2, respectively, whereas no significant associations were observed with BMI. LCA explained slightly more variance in diet quality (6% compared with 4%) compared with MDTW-based clustering, with a similar proportion observed for BMI (∼13%). The AUCs for discriminating high diet quality (LCA: 0.635 compared with MDTW: 0.616; P = 0.565) and obesity (LCA: 0.758 compared with MDTW: 0.756; P = 0.934) were not significantly different between the 2 methods. CONCLUSIONS: LCA and MDTW-based clustering identified comparable yet noninterchangeable TEPs, suggesting both approaches are suitable for deriving TEPs.
Dietary macronutrient substitutions and cardiometabolic outcomes in children with and without gestational diabetes exposure: a cross-sectional analysis.
Alves JM, Belcher BR, Luo Y … +3 more , Chow T, Xiang AH, Page KA
Am J Clin Nutr · 2026 Jun · PMID 41985676 · Full text
BACKGROUND: Prenatal exposure to gestational diabetes mellitus (GDM) increases offspring cardiometabolic risk, underscoring the need for preventive interventions. OBJECTIVES: We used isocaloric substitution to investigat...
BACKGROUND: Prenatal exposure to gestational diabetes mellitus (GDM) increases offspring cardiometabolic risk, underscoring the need for preventive interventions. OBJECTIVES: We used isocaloric substitution to investigate the associations between dietary macronutrients and cardiometabolic outcomes in children with and without GDM exposure. METHODS: Data are from 192 participants aged 7-11 y (53% GDM-exposed, 40% male) from the longitudinal BrainChild cohort. Assessments included a 24-h dietary recall, a fasting blood sample, anthropometrics, and blood pressure measurements. In a cross-sectional analysis, linear regression was used to test the effects of substituting primary macronutrients (protein, MUFA/PUFA, SFA/trans-fatty acids, mono/disaccharides, and polysaccharides) on fasting plasma glucose, insulin, HOMA-IR, total body fat, waist circumference, and systolic/diastolic blood pressure. RESULTS: Unexposed children were older (mean ± SD: unexposed, 8.9 ± 1.0; GDM-exposed: 8.6 ± 1.0), had higher fasting insulin (mean ± SD: unexposed, 5.0 ± 6.7; GDM-exposed: 4.0 ± 5.2), HOMA-IR values (mean ± SD: unexposed, 1.1 ± 1.3; GDM-exposed: 0.81 ± 1.0), and consumed fewer monosaccharides/disaccharides compared with GDM-exposed children (mean ± SD: unexposed, 345.6 ± 125.2; GDM-exposed: 396.6 ± 159.1). In GDM-exposed children, substituting 5% of daily calories from carbohydrates or fat with protein was associated with lower fasting glucose [polysaccharides: β = -13.12, 95% confidence interval (CI): -23.9, -2.33; monosaccharides/disaccharides: β = -13.35, 95% CI: -24.16, -2.54; MUFA and PUFA: β = -12.18, 95% CI: -22.76, -1.6; SFA and trans-fatty acids: β = -11.07, 95% CI: -21.55, -0.6], whereas substituting SFAs/trans-fatty acids with protein was associated with lower diastolic blood pressure: β = -7.86, 95% CI: -15.51, -0.2). In unexposed children, substituting 5% of daily calories from mono/disaccharides and protein for polysaccharides was associated with lower fasting glucose (monosaccharides/disaccharides: β = -1.09, 95% CI: -2.07, -0.12; protein: β = -4.58, 95% CI: -9.04, -0.11). Associations did not remain after adjusting for social and lifestyle factors. CONCLUSIONS: These findings reveal exposure-specific differences in how macronutrient composition influences cardiometabolic outcomes and highlight distinct intervention targets for children exposed and unexposed to GDM.
Glycemic and cardiometabolic effects of rare sugars allulose and tagatose: a systematic review and meta-analysis of controlled human intervention trials.
Osborn L, DuPuis K, Liu S … +2 more , Della Corte D, Della Corte KA
Am J Clin Nutr · 2026 Jun · PMID 41985675 · Publisher ↗
BACKGROUND: Allulose and tagatose are rare monosaccharides gaining attention as potential alternatives to added sugars. OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the effects of allulose and t...
BACKGROUND: Allulose and tagatose are rare monosaccharides gaining attention as potential alternatives to added sugars. OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the effects of allulose and tagatose supplementation on glycemic, cardiometabolic, and anthropometric outcomes in adults. METHODS: The Medline, Embase, and Cochrane libraries were searched through 30 April, 2025, for controlled human intervention trials reporting the effects of tagatose or allulose on postprandial and fasting glucose and insulin concentrations, blood lipids, uric acid, and anthropometric measures of adiposity in adults. Meta-analyses were conducted using mean differences (MDs) with random-effects models applied to all analyses. The risk of bias was evaluated using the Cochrane Risk of Bias 2 and Risk of Bias In Nonrandomized Studies-Interventions tools, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: Of 4905 initial reports, 20 trials were identified (12 allulose trials and 8 tagatose trials; 1033 participants). Allulose significantly reduced postprandial glucose [incremental AUC: standardized mean difference (SMD) = -0.66; 95% confidence interval: -0.92, -0.39; moderate certainty] and insulin [SMD = -1.27 (-2.14, -0.40); I = 96%; P = 0.03; moderate certainty], with no significant effects on glycated hemoglobin (HbA1c), fasting glucose or insulin, lipids, uric acid, or body composition (very low to moderate certainty). Tagatose intake similarly lowered postprandial glucose [SMD = -1.03 (-1.36, -0.71)] and insulin [SMD = -1.05 (-1.61, -0.49); both moderate certainty] and also reduced HbA1c [MD = -0.25 (-0.44, -0.06); moderate certainty] and fasting insulin [MD = -80.40 (-136.96, -23.84); very low certainty]. No other significant pooled effects were observed. CONCLUSIONS: Supplementation of allulose or tagatose attenuates postprandial glycemic and insulin responses, albeit with no improvements in blood lipids and body composition. This trial was registered at PROSPERO as CRD42024567433.
Corrigendum to Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society [Am J Clin Nutr 2025; 122: 344-367].
Mozaffarian D, Agarwal M, Aggarwal M … +15 more , Alexander L, Apovian CM, Bindlish S, Bonnet J, Butsch WS, Christensen S, Gianos E, Gulati M, Gupta A, Horn D, Kane RM, Saluja J, Sanndhi D, Stanford FC, Callahan EA
Am J Clin Nutr · 2026 Jun · PMID 41962912 · Publisher ↗
Abstract loading — click title to view on PubMed.
Associations between extreme temperature events and daily step counts by weight status and modifying effects of sociodemographic factors: a longitudinal study.
Lin Z, Li Y, Shi Y … +11 more , Li J, Wang Z, Xu J, Lawrence WR, Chen S, Zhang W, Hu J, He G, Liu T, Zhang M, Ma W
Am J Clin Nutr · 2026 Jun · PMID 41962745 · Full text
BACKGROUND: Although the health risks of increasing extreme weather events such as heatwaves and cold spells are well recognized, there remains a research gap on how these events specifically affect physical activity, pa...
BACKGROUND: Although the health risks of increasing extreme weather events such as heatwaves and cold spells are well recognized, there remains a research gap on how these events specifically affect physical activity, particularly among individuals with different weight status. In addition, limited attention has been given to how sociodemographic factors might interact with extreme weather to influence physical activity. OBJECTIVES: This study aimed to examine the association between extreme weather events and daily step counts by body weight and to investigate whether these associations are modified by other sociodemographic factors. METHODS: To address this, we conducted a longitudinal panel study in Henan Province, China, and applied distributed lag nonlinear models to examine how daily step counts were influenced by extreme weather events-including heatwaves and cold spells-and their intensity and duration. We also explored whether sociodemographic factors modified these effects. RESULTS: Our findings showed that extreme weather events significantly reduced step counts. Specifically, heatwaves were associated with a substantial decline in individuals with overweight [-959.68 steps; 95% confidence interval (CI): -1198.13, -721.22], which was significantly larger than the reduction observed in participants with normal weight (-331.16 steps; 95% CI: -625.50, -36.83). Conversely, cold spells were associated with a disproportionately larger reduction in step counts among participants with normal weight (-1832.46 steps; 95% CI: -2136.15, -1528.76), compared with a milder reduction in the overweight group (-1067.66 steps; 95% CI: -1317.40, -817.91). Interaction analysis revealed that high income consistently attenuated these disparities (P-interaction < 0.05). Although age and sex also modified these associations, body weight emerged as a primary factor. CONCLUSIONS: These findings suggest that individuals with low income or high body mass index (BMI) are associated with heightened vulnerability to heatwaves, whereas individuals with low income or normal BMI are linked to greater sensitivity during cold spells.
Sustained effects of combined maternal and child small-quantity lipid-based nutrient supplements in early life on growth and developmental outcomes at preschool age: an individual participant data analysis of randomized trials in Ghana and Bangladesh.
Dewey KG, Arnold CD, Matias SL … +7 more , Adu-Afarwuah S, Demuyakor ME, Kumordzie SM, Mridha MK, Oaks BM, Okronipa H, Tofail F
Am J Clin Nutr · 2026 Jun · PMID 41962744 · Full text
BACKGROUND: There is limited evidence regarding the sustained impact of nutritional supplementation provided during both pregnancy and infancy. OBJECTIVES: We compared growth and development between preschool children pr...
BACKGROUND: There is limited evidence regarding the sustained impact of nutritional supplementation provided during both pregnancy and infancy. OBJECTIVES: We compared growth and development between preschool children previously exposed to maternal and child small-quantity lipid-based nutrient supplements (SQ-LNS) and those not exposed. Secondarily, we compared outcomes between children exposed to both maternal and child SQ-LNS compared with only child SQ-LNS. For both questions, we examined potential effect modifiers. METHODS: We conducted a 2-stage individual participant data meta-analysis of randomized controlled trials in Ghana and Bangladesh that provided SQ-LNS to pregnant participants and their children aged 6 to 18-24 mo, and reassessed the cohorts at ages 40-78 mo. Growth outcomes included weight-for-age (WAZ) and height-for-age (HAZ) z-scores and indicators of body composition. Development outcomes included language, visual-spatial, executive function, and preacademic skills. RESULTS: In the overall sample (n = 3565), WAZ was higher [mean difference (95% confidence interval): +0.06 (0.01, 0.11)] among preschool children exposed compared with not exposed to maternal plus child SQ-LNS, but body composition and development did not differ. Child sex was a significant effect modifier for several outcomes, indicating positive effects among females [e.g., WAZ +0.16 (0.08, 0.24), HAZ +0.15 (0.06, 0.23), and language development z-score +0.12 (0.02, 0.22)] but no significant effects among males [WAZ -0.04 (-0.14, 0.05), HAZ -0.03 (-0.3, 0.08), language -0.03 (-0.13, 0.08); P-interaction < 0.01]. Outcomes did not differ between children exposed to maternal plus child SQ-LNS compared with only child SQ-LNS; however, among females, the addition of maternal SQ-LNS positively affected growth, whereas the opposite was observed among males. CONCLUSIONS: We observed a sustained impact of maternal plus child SQ-LNS on growth and language development among female children, but not among males. Further research is needed to investigate mechanisms underlying the sex difference in response to nutrient supplementation in early life. The trial in Ghana was registered as NCT00970866 on 2 September, 2009, at https://clinicaltrials.gov/search?term=NCT00970866. The trial in Bangladesh was registered as NCT01715038 on 23 October, 2012, at https://clinicaltrials.gov/search?term=NCT01715038.
Intention-to-treat estimates of prenatal Ramadan exposure on child height-for-age in the demographic and health surveys.
Chaudhry TT
Am J Clin Nutr · 2026 Apr · PMID 41962743 · Publisher ↗
BACKGROUND: Prior research on the intention-to-treat (ITT) effect of prenatal Ramadan exposure on child growth has yielded conflicting results: most studies found reduced height for age, whereas others produced null or c...
BACKGROUND: Prior research on the intention-to-treat (ITT) effect of prenatal Ramadan exposure on child growth has yielded conflicting results: most studies found reduced height for age, whereas others produced null or counterintuitively positive effects. These inconsistencies may stem from seasonality confounding, improper control group choices, short-timespan data collection, and violations of the parallel-trend assumption. OBJECTIVES: This study reconciled conflicting results using over 1.25 million height-for-age measurements from 145 demographic and health surveys (DHSs) across 44 countries (1990-2021). METHODS: A difference-in-difference ITT analysis was conducted using DHS data. Ramadan exposure measures the proportion of Ramadan overlapping with the child's time in utero, regardless of whether the mother fasted, avoiding bias from selective fasting behavior. Furthermore, the analysis controlled for growth faltering and cohort fixed effects and restricted the analysis to a sample of multifaith regions since over 50% of DHS observations come from religiously homogeneous regions. RESULTS: Counterintuitive findings were replicated in the full sample (n = 1,277,535). In the 10%-90% Muslim multifaith sample (n = 583,790), prenatal Ramadan exposure had no significant effect from ages 0 to 2 years. Negative effects emerged from age 3 onward: the total effect on Muslim children relative to nonexposed Muslim children was -0.06 z-score points at age 3 (P = 0.033) and -0.1 at age 4 (P < 0.001). The differential effect relative to non-Muslim children at age 4 was -0.08 z-score points (P = 0.020). Results were similar in the 15%-85% sample (n = 436,905; -0.1 z-score points at age 4; P = 0.02), with no spurious effects on the non-Muslim control group. CONCLUSIONS: Restricting samples to multifaith regions and accounting for growth faltering resolves conflicting findings, yielding a robust negative effect of 0.1 z-score points by age 4. Further research is needed to disentangle the specific pathways, including fasting, dietary changes, hydration, and sleep disruption, through which Ramadan exposure affects fetal development, in order to inform targeted public health guidance.
Determining the half-life and turnover rate of EPA, n-3 docosapentaenoic acid, and DHA in humans using the natural abundance of carbon-13: a secondary analysis of a randomized clinical trial.
Symington A, Wu D, Chen CT … +7 more , Del Vecchio M, Zahradka P, Taylor C, Aukema HM, Kong D, Metherel AH, Bazinet RP
Am J Clin Nutr · 2026 Jun · PMID 41956323 · Full text
BACKGROUND: Tools to measure omega-3 (n-3) polyunsaturated fatty acid (PUFA) half-lives and turnover deserve attention, as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play vital roles in the body. Plants a...
BACKGROUND: Tools to measure omega-3 (n-3) polyunsaturated fatty acid (PUFA) half-lives and turnover deserve attention, as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play vital roles in the body. Plants and marine life vary in fixed carbon-13 signatures (δC), allowing in vivo tracing. OBJECTIVES: To determine the half-lives and turnover of n-3 PUFAs using δC in this secondary analysis. METHODS: During a 28-d randomized crossover study (6-wk wash-in phase/washout phase), 12 participants (aged 19-34 y) were supplemented with 4.2 g/d α-linolenic acid (ALA) (flax oil) or 4.3 g/d DHA, 1.0 g/d EPA, and 0.2 g/d docosapentaenoic acid (n-3 DPA) (fish oil). Blood was collected on days 0, 1, 3, 7, 14, and 28. Plasma n-3 PUFA δC signatures were analyzed by gas chromatography-isotope ratio mass spectrometry (GC-IRMS) to calculate half-lives and turnover. RESULTS: δC signatures of flax oil ALA, fish oil EPA, n-3 DPA, and DHA were -33.2 ± 1.4, -26.3 ± 2.2, -26.2 ± 1.5, and -25.4 ± 1.3 mUr, respectively. Baseline signatures were not statistically different. Over time, δC of EPA, n-3 DPA, and DHA converged toward the isotopic signature of the fish oil supplement (P < 0.05). Using δC signatures, half-lives of EPA, n-3 DPA, and DHA (3.4 ± 2.7, 6.4 ± 5.3, and 6.3 ± 8.9 d, mean ± SD, respectively) and turnover rates (61.9 ± 53.1, 6.0 ± 2.9, and 78.0 ± 44.5 nmol/mL/d, respectively) were calculated. CONCLUSIONS: This is the first study to investigate n-3 PUFA half-lives and turnover in humans using GC-IRMS and the natural variance of C in commercial fish oils. These results were similar to preclinical model values and other clinically used methods but added the first estimate for n-3 DPA half-life and turnover rate. Compound-specific isotope analysis is a valuable tool in human studies for determining n-3 PUFA half-lives and turnover rate, as well as factors affecting them, including diet, exercise, sex, genetics, and disease.
Should the Dietary Guidelines for Americans include sustainability? A critical perspective.
Conrad Z
Am J Clin Nutr · 2026 Jun · PMID 41951002 · Publisher ↗
The move to include sustainability in the Dietary Guidelines for Americans (DGA) can seem like an obvious response to some of the biggest threats to all domains of sustainability: health, environment, economy, and societ...
The move to include sustainability in the Dietary Guidelines for Americans (DGA) can seem like an obvious response to some of the biggest threats to all domains of sustainability: health, environment, economy, and society. But it has been controversial. This perspective paper describes the evolution of this idea, critically appraises the arguments for and against, and considers ways to move this conversation forward. Since the inception of this idea in 1986, it has always been a source of unresolved controversy fueled by categorical arguments rather than nuanced discussions. At the center of this controversy has been questions about the strength of the evidence for nutrition-sustainability relationships, whether the DGA is the appropriate venue to communicate this information to the public, and the policy implications for sectors outside of nutrition. This timeline has been punctuated by flash points along the way, notably the inclusion of sustainability in the 2010 DGA and the 2015 Dietary Guidelines Advisory Committee report, which led to intense partisan fallout. Sustainability has not been included in the DGA process since then, to the consternation of many nutrition professionals. What has been missing is a nuanced and critical discussion of the evidence base that links nutrition with sustainability, ways to communicate that evidence to the public, and approaches for developing integrated policies that reduce inertia. The relationship between nutrition and sustainability is characterized by tradeoffs that need to be acknowledged by scientists, clinicians, and policymakers. The federal government, which has responsibility for translating the scientific evidence into publicly accessible dietary guidance, is not currently well-positioned to communicate the nuances of nutrition-sustainability science to the general public. Most clinicians are not trained to do that either. In addition, the DGA has far-reaching implications for nondietary policy, which have not been fully considered yet. Until we, as nutrition professionals, can have productive conversations about the nuances related to science, messaging, and policy, a push to include sustainability in the DGA will be counterproductive.
Effect of soluble corn fiber supplementation for 1 year on bone mass in children and adolescents: results from the MetA-Bone randomized clinical trial.
Palacios C, Trak-Fellermeier MA, Hernandez J … +10 more , Galvan R, Martinez-Motta P, Machi A, Sifre-Acosta N, Clayton PK, Hernandez Y, Martinez R, Gambon T, Bursac Z, Weaver CM
Am J Clin Nutr · 2026 Jun · PMID 41936980 · Full text
BACKGROUND: Prebiotic fiber supplementation increases calcium absorption but its long-term effects on bone mass are mixed in children and adolescents. OBJECTIVES: This study aimed to determine the effect of 1-y soluble c...
BACKGROUND: Prebiotic fiber supplementation increases calcium absorption but its long-term effects on bone mass are mixed in children and adolescents. OBJECTIVES: This study aimed to determine the effect of 1-y soluble corn fiber (SCF) supplementation compared with that of placebo (maltodextrin; main comparison), with or without calcium (calcium gluconate; secondary comparison) on bone mineral content (BMC) and bone mineral density (BMD) in children and adolescents with low habitual calcium intake through a randomized clinical trial. We hypothesized that SCF supplementation would result in higher bone mass. METHODS: Healthy children and adolescents (9-14 y old) with usual low calcium intake were recruited and randomly assigned for 1 y to SCF (12 g/d) or placebo (12 mg/d), with or without calcium (600 mg/d). Bone mass was measured using dual-energy x-ray absorptiometry at baseline, 6 mo, and 12 mo. Results are shown as mean ± SD. Statistical analyses included linear mixed-effects and analysis of variance. RESULTS: Totally, 213 participants were recruited, of whom 177 were randomized. Most were White (41.3%), Hispanic (69.5%), and with healthy weight (74.0%). Girls had significantly higher Tanner score (3.10 ± 1.20) than boys (2.30 ± 1.20; P < 0.001) and a significantly higher body fat percentage (P < 0.05); therefore, results were stratified by sex. Among completers (n = 151), whole-body BMC and BMD significantly increased from baseline to 6 mo and to 12 mo. In girls, 1-y gain in whole-body BMC was higher with SCF (216.3 ± 138.3 g or 18.8%) than with placebo (139.9 ± 84.0 g, 12.9%) after adjusting for age, Tanner stage, height velocity, weight velocity, lean mass velocity, fat mass velocity, and compliance (P < 0.05). Similar results were found for BMD in girls. This was not observed in boys or when calcium supplementation was added. CONCLUSIONS: A 1-y supplementation with SCF results in higher whole-body BMC and BMD than placebo in girls only. This effect could have potential long-term benefits on bone mass acquisition in girls. This trial was registered at clinicaltrials.gov as NCT02916862 (https://clinicaltrials.gov/study/NCT02916862).
Concerns for United States food security amid changes in work requirements of the Supplemental Nutrition Assistance Program (SNAP) and the termination of nutrition education through the Supplemental Nutrition Assistance Program-Education (SNAP-Ed).
Eicher-Miller HA, Gundersen C
Am J Clin Nutr · 2026 Jun · PMID 41936979 · Publisher ↗
Food insecurity is a situation of limited food access because of not having enough resources that ∼14% of the United States population experienced in 2023. The federal food assistance program, Supplemental Nutrition Assi...
Food insecurity is a situation of limited food access because of not having enough resources that ∼14% of the United States population experienced in 2023. The federal food assistance program, Supplemental Nutrition Assistance Program (SNAP), and its accompanying nutrition education program, SNAP-Education (SNAP-Ed), have kept these estimates as low as they are. The legislation enacted through the One Big Beautiful Bill Act in 2025 changed both programs, imposing expanded SNAP work requirements and completely terminating SNAP-Ed. We comment on how these changes may impact those who were formerly eligible or participating in these programs and argue for the elimination of SNAP work requirements and the expansion of SNAP-Ed to provide more support toward health and food security for all Americans.
Artificial Intelligence and Machine Learning Resource Guide: The Academy of Nutrition and Dietetics and the American Society for Nutrition Joint Taskforce for Artificial Intelligence.
Murofushi K, Thomas D, Dhakal S … +6 more , Park H, Kleinberg S, Salvia M, Jessri M, Kittrell H, Cataldo A
Am J Clin Nutr · 2026 May · PMID 41934049 · Publisher ↗
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Circulating saturated fatty acids and incident chronic kidney disease: a meta-analysis of de-novo prospective cohort investigations.
Lidgard B, Fretts AM, Zelnick LR … +39 more , van Westing AC, Geleijnse JM, Steur M, Samieri C, Helmer C, Le Goff M, Chen YY, Chien KL, Ong KL, Mozaffarian D, Siscovick D, Wu JH, de Boer IH, Imamura F, Forouhi NG, Wareham NJ, Birukov A, Jäeger S, Schulze MB, Tuomilehto J, Uusitupa M, Lindström J, Tintle N, Harris WS, Yamasaki K, Hirakawa Y, Ninomiya T, Virtanen JK, Voutilainen A, Senn MK, Rich S, Tsai MY, Wood AC, Yang X, Sun L, Li H, Lin X, Lemaitre RN, Fatty Acids and Outcomes Research Consortium (FORCE)
Am J Clin Nutr · 2026 Apr · PMID 41932768 · Full text
BACKGROUND: Chronic kidney disease (CKD) is a global health problem which is associated with poor outcomes, and its prevalence is expected to increase. Identifying novel risk factors for CKD may lead to improved outcomes...
BACKGROUND: Chronic kidney disease (CKD) is a global health problem which is associated with poor outcomes, and its prevalence is expected to increase. Identifying novel risk factors for CKD may lead to improved outcomes. Circulating saturated fatty acids (SFAs) have been posited as contributors to CKD risk. OBJECTIVES: We aimed to evaluate associations between circulating SFAs (measured in phospholipids in 7 cohorts, serum or plasma total in 5 cohorts, and cholesterol esters in 1 cohort) and incident CKD in 13 cohorts, and to pool results by meta-analysis across the studies. METHODS: SFAs were measured in 13 cohorts in the Fatty Acids Outcomes Research Consortium, including 18,193 participants with estimated glomerular filtration rate >60 mL/min/1.73 m across 9 countries. Associations between each SFA [palmitic acid (16:0), stearic acid (18:0), arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0)] and incident CKD (defined as an estimated glomerular filtration rate <60 mL/min/1.73 mand ≥25% decrease from baseline) were assessed by Cox or Poisson regressions. Results were pooled using inverse variance weighted meta-analysis. RESULTS: In total, 2554 participants developed CKD over a weighted median follow-up of 7.6 y. After adjustment, higher concentrations of 18:0 were associated with a lower risk of CKD with minimal heterogeneity (relative risk per interquintile range: 0.87; 95% confidence interval: 0.80, 0.95, P = 0.003, I = 14.7%). These associations remained consistent in secondary and sensitivity analyses. We did not observe significant associations of other SFAs with CKD. CONCLUSIONS: In a meta-analysis of 18,193 participants across 9 countries, we observed no indication that SFA increased CKD risk, whereas higher 18:0 concentrations were associated with a lower risk of CKD. Future research is needed to assess mechanisms by which SFA 18:0 may exert kidney-protective effects, and how circulating SFA 18:0 concentrations may be altered.
Paternal healthy lifestyle and preterm birth among married Chinese couples planning to conceive: a population-based cohort study.
Xiong W, Wang X, Fan C … +3 more , Chen S, Han L, Ling L
Am J Clin Nutr · 2026 Apr · PMID 41932767 · Publisher ↗
BACKGROUND: Females with healthy lifestyles have a lower risk of preterm birth (PTB). However, the association between paternal healthy lifestyle and PTB risk is not well investigated. OBJECTIVES: This study aimed to eva...
BACKGROUND: Females with healthy lifestyles have a lower risk of preterm birth (PTB). However, the association between paternal healthy lifestyle and PTB risk is not well investigated. OBJECTIVES: This study aimed to evaluate the association between an overall paternal healthy lifestyle and risk of PTB in their offspring. METHODS: The population-based, retrospective cohort included 810,475 couples who participated in the National Free Preconception Checkups Project in Guangdong Province, China, and successfully had a singleton livebirth between 1 January, 2014 and 1 November 1, 2019. A combination of paternal healthy lifestyle was measured: no smoking, no drinking, and healthy body mass index (18.5-23.9 kg/m). Associations between healthy lifestyle factors and PTB risk were estimated by modified Poisson regression models with inverse probability of treatment weighting. RESULTS: After accounting for key maternal risk factors such as maternal age, parity, and maternal healthy lifestyle, risk ratios of infants experiencing PTB for couples where the male partner had a healthy lifestyle score of 1, 2, and 3 compared with a healthy lifestyle score of 0 were 0.94 (95% confidence interval: 0.90, 0.99), 0.94 (0.90, 0.98), and 0.90 (0.86, 0.94), respectively (P < 0.001). However, the association between paternal healthy lifestyle and PTB was only statistically significant among the subset of males evaluated for lifestyle factors >90 d before pregnancy. When shifting these 3 paternal unfavorable lifestyle factors, population attributable risk estimation suggests that 2.37% (1.90%, 4.65%) of PTB cases might be prevented. We did not find statistically significant additive interaction of paternal and maternal healthy lifestyles on risk of PTB (relative excess risk due to interaction: -0.04; -0.09, 0.01). CONCLUSIONS: Paternal healthy lifestyle was independently associated with a lower risk of PTB in their offspring. These findings highlight the importance of including lifestyle modifications among males to improve pregnancy outcomes.
Circulating saturated fats and chronic kidney disease: A more nuanced picture.
de Souza RJ
Am J Clin Nutr · 2026 Apr · PMID 41932766 · Publisher ↗
Abstract loading — click title to view on PubMed.
Birthplace and nutrient intake across ethnic subgroups: a cross-sectional analysis of the NHANES.
Sanchez-Vaznaugh EV, Matsuzaki M, Acosta ME … +2 more , Barba N, Sánchez BN
Am J Clin Nutr · 2026 Apr · PMID 41932765 · Full text
BACKGROUND: Prior research found birthplace differences in dietary intake among Hispanic and Black populations. Research is needed to compare food and nutrient intake between immigrants and natives of United States using...
BACKGROUND: Prior research found birthplace differences in dietary intake among Hispanic and Black populations. Research is needed to compare food and nutrient intake between immigrants and natives of United States using a wider range of ethnic subpopulations. OBJECTIVES: This study aims to investigate the association between birthplace and nutrient intake among 4 ethnic population subgroups. METHODS: Cross-sectional data from adult respondents in the NHANES waves 2007-2008 through 2017-2018, linked with the Food Pattern Equivalents Database and linear regression models estimated birthplace differences [immigrants compared with United States-born (reference)] in the consumption of added sugars, total and saturated fat, sodium, whole grains, and fiber. Models were stratified by ethnicity: Hispanic, non-Hispanic (NH)-Asian, NH-Black, and NH-White. RESULTS: The analyses included 6185 Hispanic; 12,067 NH-White; 5932 NH-Black and 2051 NH-Asian adults. Within each ethnic group, strong evidence showed immigrants exhibited lower intake of added sugars (coefficients ranged from -2.97 to -7.51 depending on the ethnic group, all P < 0.05), total fats (range: -7.18 to -21.21), and saturated fats (range: -2.53 to -6.91) than their United States-born coethnics after controlling for covariates. Hispanic (4.0), NH-Asian (2.21), NH-Black (3.61), and NH-White (2.56) immigrants reported higher fiber intake (P < 0.05), whereas only NH-Black (0.57) and NH-White immigrants (0.21) showed higher whole grain consumption than their United States-born coethnics, after covariate adjustments. Hispanic (-142.1) and NH-Black immigrants (-76.9) reported lower sodium intake compared with their United States-born coethnics (P < 0.05). CONCLUSIONS: Across the 4 ethnic populations, immigrants generally exhibited better intake of the nutrient examined relative to United States-born coethnics, suggesting a protective immigrant effect. Research to understand reasons for these differences is warranted. Furthermore, future nutrition interventions may require tailored approaches to help maintain healthy nutrient profiles among immigrants, while reducing intake of sodium, saturated fat, and added sugars and increasing fiber and whole grain intake among all populations.
Adherence to the Dietary Approaches to Stop Hypertension score and cardiovascular disease risk in Korean adults: a prospective cohort study using marginal structural models.
Kim SH, Kim H, Shin D
Am J Clin Nutr · 2026 Jun · PMID 41903890 · Full text
BACKGROUND: The prevalence and mortality of cardiovascular disease (CVD) have increased in Korea. Although the Dietary Approaches to Stop Hypertension (DASH) diet is widely recognized for its association with CVD risk, e...
BACKGROUND: The prevalence and mortality of cardiovascular disease (CVD) have increased in Korea. Although the Dietary Approaches to Stop Hypertension (DASH) diet is widely recognized for its association with CVD risk, evidence in Korean populations remains limited. OBJECTIVES: This study examined the association between DASH adherence and CVD incidence among Korean adults using statistical approaches that account for time-varying exposure and selection bias. METHODS: We analyzed data from 6646 adults in the Ansan-Ansung cohort of the Korean genome and epidemiology study from baseline (2001-2002) through the ninth follow-up (2019-2020). DASH scores were calculated from the food frequency questionnaire. CVD outcomes included myocardial infarction, stroke, coronary artery disease, and congestive heart failure. Associations were evaluated using Cox proportional hazards models and marginal structural models (MSMs) to address time-varying confounding and informative censoring. RESULTS: Mean DASH scores (mean ± SD) were lower in male participants (22.5 ± 4.2) than in female participants (25.4 ± 3.7). In multivariable-adjusted models, higher DASH adherence was associated with lower CVD incidence among female participants [quintile 5 compared with quintile 1: hazard ratio (HR): 0.60; 95% confidence interval (CI): 0.36, 0.99], with a nonlinear trend observed in restricted cubic spline analyses. No significant association was found in male participants. MSM's estimates were consistent with Cox's results (HR: 0.53; 95% CI: 0.28, 0.99). Among individual DASH components, higher sodium intake was associated with increased CVD risk in female participants (HR: 1.30; 95% CI: 1.03, 1.65). CONCLUSIONS: Higher adherence to the DASH diet was associated with lower CVD incidence among female participants. Consistent findings across Cox and MSMs analyses provide supportive evidence under causal assumptions. These findings suggest that the DASH dietary pattern may inform population-level dietary strategies for CVD prevention in Korean adults.
Magnesium supplementation did not reduce serum calciprotein crystallization and arterial stiffness in individuals with type 2 diabetes: a randomized, double-blind, placebo-controlled trial.
Meer R, Xu JY, Newsom SP … +5 more , Pasch A, Vervloet MG, de Jong PA, Elders PJ, Beulens JW
Am J Clin Nutr · 2026 May · PMID 41903889 · Full text
BACKGROUND: Medial arterial calcification (MAC) and increased arterial stiffness contribute to cardiovascular disease risk in type 2 diabetes mellitus (T2DM). Experimental studies suggest that magnesium supplementation m...
BACKGROUND: Medial arterial calcification (MAC) and increased arterial stiffness contribute to cardiovascular disease risk in type 2 diabetes mellitus (T2DM). Experimental studies suggest that magnesium supplementation may halt arterial calcification and improve arterial stiffness. OBJECTIVES: This study aimed to evaluate the effect of 6-mo oral magnesium citrate supplementation on calciprotein crystallization (T) and carotid-femoral pulse wave velocity (cfPWV) in individuals with T2DM and peripheral MAC. METHODS: This double-blind, placebo-controlled trial randomly assigned 74 participants with T2DM [78% males, 72 (68-76) y] with peripheral MAC and cfPWV≥12.0 m/s to magnesium citrate (350 mg/d; n = 37) or placebo (n = 37). Nephelometry-based T measurements, cfPWV measurements, and 24-h urine collections were obtained at baseline, 3 and 6 mo. Longitudinal analysis of covariance adjusted for baseline T and cfPWV was used to study the treatment effects on T and cfPWV. RESULTS: Baseline mean T and cfPWV were similar between the magnesium group (T 348 ± 54 min; cfPWV 15.9 ± 2.2 m/s) and the placebo group (362 ± 54 min; 15.6 ± 2.0 m/s). Magnesium in serum and in 24-h urine were lower in the magnesium group [0.74 (0.71-0.77) mmol/L and 3.30 (2.06-4.71) mmol/24 h] compared with the placebo group [0.81 (0.74-0.86) mmol/L and 4.31 (3.09-5.54) mmol/24 h]. Supplementation increased 24-h urine magnesium excretion (P < 0.001), but not serum magnesium concentration (P = 0.073) over time in the magnesium group relative to the placebo group. Magnesium supplementation did not increase T [ẞ = 6 min (-11, 22), P = 0.491] but did increase cfPWV [ẞ = 0.8 m/s (0.1, 1.5), P = 0.021] over 6 mo in the magnesium group relatively to the placebo group, but the statistical significance was lost after adjusting for clinically relevant baseline differences [T: ẞ = 7 min (-12, 25), P = 0.482; cfPWV: ẞ = 0.5 m/s (-0.2, 1.3), P = 0.180]. CONCLUSIONS: Six-month magnesium citrate supplementation did not reduce calciprotein crystallization and arterial stiffness in older individuals with T2DM with peripheral MAC. Daily supplementation of 350 mg appears to be ineffective in this population, possibly attributable to normomagnesemia and preserved renal function. This study was registered at the Dutch Trial Register (CCMO) as NL81281.029.22 and at ISRCTN as 60460377.
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